Determinants of progression of nicotine dependence symptoms in adolescent waterpipe smokers.
Determinants of progression of nicotine dependence symptoms in adolescent waterpipe smokers.
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DOI：
10.1136/tobaccocontrol-2018-054244
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发表时间：
2019-05
期刊：
影响因子：
5.2
通讯作者：
Maziak W
中科院分区：
文献类型：
--
作者：
Bahelah R;Ward KD;Ben Taleb Z;DiFranza JR;Eissenberg T;Jaber R;Maziak W
水烟吸烟继续对烟草控制工作构成重大挑战，许多青少年水烟吸烟者出现尼古丁依赖（ND）的症状。本研究探讨了青少年水烟吸烟者ND症状进展的预测因素。我们召集了一群黎巴嫩八年级和九年级的青少年，在接下来的24个月里每6个月对他们进行一次调查。ND症状的进展被定义为随着时间的推移，尼古丁上瘾清单（HONC）上的项目数量增加。预测因素包括个人（如心理因素、对水管的态度、学校表现、体育活动）和社会环境（如父母、兄弟姐妹和亲密朋友吸烟；咖啡环境）属性。264名青少年水烟吸烟者（基线平均年龄为14.6岁，50.4%为女性）中，105名（39.7%）在随访期间出现ND症状进展。病情进展的预测因子为较高的基线压力（OR=1.11, 95% CI: 1.03-1.19）和较高的自尊（OR=1.14, 95% CI: 1.05-1.24）。报告在餐馆中难以控制水烟是进展的最强预测因子（OR=4.04, 95% CI: 1.44-11.34）。母亲受教育年限≥12年可防止ND进展（OR=0.46, 95% CI: 0.21-0.99）。相当比例的青少年水烟吸烟者发展为ND。以场所为基础的政策，如限制青少年获得水管咖啡是必要的。
Waterpipe smoking continues to pose significant challenges to tobacco control efforts and many adolescent waterpipe smokers experience symptoms of nicotine dependence (ND). This study examined the predictors of progression of ND symptoms in adolescent waterpipe smokers. We assembled a cohort of Lebanese adolescents enrolled in 8th and 9th grades at baseline, and surveyed them every 6 months over the next 24 months. Progression of ND symptoms was defined as an increase over time in the number of items endorsed on the Hooked on Nicotine Checklist (HONC). Predictors included individual (e.g., psychological factors, attitudes towards waterpipe, school performance, physical activity), and socio-environmental (e.g., smoking among parents, siblings, and close friends; the café environment) attributes. Among 264 adolescent waterpipe smokers (baseline mean age=14.6 years, 50.4% females), 105 (39.7%) progressed on ND symptoms during follow up. Predictors of progression were higher baseline stress (OR=1.11, 95% CI: 1.03–1.19), and higher self-esteem (OR=1.14, 95% CI: 1.05–1.24). Reporting difficulty refraining from smoking waterpipe while in a restaurant was the strongest predictor of progression (OR=4.04, 95% CI: 1.44–11.34). Having a mother with ≥12 years of education protected against progression of ND (OR=0.46, 95% CI: 0.21–0.99). A significant proportion of adolescent waterpipe smokers progressed on ND. Venue-based policies such as limiting youth access to waterpipe cafés is warranted.
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4.7
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